Stone, or Lithiasis, is a con-ion of calcareous matter, form-n different organs of the body, but particularly in the kidnies, uri-nary passage, and biliary duels ; though other parts are not exempt from it influence : thus, accumulations of this kind have frequently been discovered, upon dissection, in the heart, brain, lungs, intestines, etc. of various size, shape, weight, and number. There are instances, where more than 200 small stones have been gradually voided by stool.
An inquiry into the nature of these morbid productions being foil to our purpose, we shall briefly state, that they probably originate from a deposition of certain particles of the blood, which cohere to any small body they may find in their passage, thus forming the nucleus or basis. Hence we shall confine our attention to the practical treatment of this dreadful malady, in the instances before mentioned ; and commence with the urinary stones, as being the most frequent. These are situated either in the kidnies, urinary ducts, bladder, or urethra.
Symptoms of the stone in the kidnies: - An obtuse pain about the loins ; nausea and vomiting; small pieces of calcareous matter are discharged with the urine ; but, if the concretion be settled in the bladder, an uneasiness will be felt at the end of the urinary passage, especially in emitting the water, which suddenly stops; or, it can be passed only when lying on the back: the urine is of various colours, and often tinged with blood ; and, if the accumulation be of a considerable size, a fixed pain prevails about the neck of the bladder. More certain signs, however, for ascertaining the presence of a stone, are the following : 1. when the discharge of urine is accompanied with small pieces of such stony matter; and, 2. by sounding, which is performed; either by the introduction of the finger into the anus, or of the catheter into the bladder.
Causes : - This distressing affliction may be induced by a great variety of circumstances, especially by improper articles of diet (see Gravel) ; though, in some countries, it is endemial, where a peculiar disposition in the habits of the people promotes its formation. These painful concretions have, likewise, been observed to be very common in the countries provided only with hard spring waters, which constitute the daily beverage of the inhabitants: they may also arise from too copious use of acids, and certain wines, for instance, Moselle and Rhenish, or Old Hock; not less than from cheese, and other gross aliment. Farther, well-attested instances have occurred, in which this excruciating disorder was occasioned by the shot swal-lowed with game, and even by the dust from mill-stones, mixed with the flour.
During the passage of stones from the kidnies into the bladder, the patient is afflicted with pain, vomiting, &:c. which form the paroxysm of the gravel and stone ; being sometimes even attended with inflammation (see Kidnies). In the bladder, they are mostly productive of pan; strangury; bloody urine; inflammation ; though in some instances they have remained in a dormant state for a considerable time ; and, unless removed by proper means, death closes the scene.
Cure : - An endless variety of remedies, under the name of li-thontriptics, have been recommended, for dissolving the stone ; but as an account of ail these pretended specifics would be equally tedious and useless, we shall only mention such as appear best adapted to the purpose. A preparation, which formerly stood in great repute, is the caustic ley, which, however, requires mucilaginous or gelatinous drink as a vehicle : thus, it was administered with great secrecy by an empiric of the name of Chittick, to whom the patients sent a vessel containing veal-broth, which he returned with the medicine mixed in the liquor, and secured by a lock : for this exposition we are indebted to Mr. Blackrie. It is evident, that great caution is requisite in the dose of so active a medicine. Considerable benefit has been derived from the use of water impregnated with fixed air, as directed by Dr. Falconer. - An infusion of the seeda of wild carrot (Daucus sylvestris, L.) sweetened with honey, is a simple and much esteemed remedy. - The late Dr. De Haen, recommended the Bear-whortleberry (Arbutus Uva ursi, L.) as a most efficacious remedy for the stone : it may be taken in doses of from one scruple to half a dram in powder, twice or three times a day ; or, in the form of an infusion thus prepared: Take of bear-whortle-berry leaves three drams, and boiling water one pint: after simmering for one or two hours, the liquor should be strained ; and from two to three table-spoonfuls may be given twice or three times a day. - Lime-water has likewise proved beneficial in this complaint, both when taken internally, and injected into the bladder. - Another simple remedy has been prescribed with great success by Dr. Mac-bridE : thirty berries of raw coffee ought to be boiled in a quart of pure water, till it acquire a deep greenish colour; of this li-quor about half a pint is to be taken, morning and evening, with 10 drops of sweet spirit of nitre : during such course, the bowels should be occasionally opened, by a dose of castor-oil. Similar attention ought to be paid, when any of the other remedies are administered ; and their operation may also be assisted by the use of mild diuretics. In their diet, patients should avoid coarse and heavy provisions, such as salted, dried, or smoked animal food, especially substances of an oily nature, and all high-seasoned dishes : farther, red-port, Rhenish, and Moselle wines, are uncommonly pernicious ; as they naturally promote the accumulation of stones: the beverage ought, therefore, to consist of cooling diluents, in which some mucilage of gum arabic or tragacanth is dissolved. - Symptoms of violent pain may be relieved by emollient clysters with opium.
Should, however, all endeavours of dissolving the stony concretion prove abortive, recourse must be had to an operation, as the only eventual means of extirpating the disease. If the stone should be retained in the urinary passage, speedy application must be made to a professional man; because delay, or neglect, cannot fail to increase the evil.
Gall-stones, or concretions formed in the biliary ducts, are of various size and colour. There is a fulness and pain about the stomach ; loss of appetite ; languor; nausea ; colic; vomiting; and restlessness: the eyes have a yellowish appearance ; and jaundice is a frequent attendant on the disorder.
With a view to expel such biliary concretions, the patient may first resort to a warm bath, and then take a gentle emetic ; though, in plethoric habits, or if the pain be violent, a small portion of blood may be drawn from the arm, and an opiate given ; in order to allay the spasms. But, where the symptoms do not abate after the second ling and emetic, medical advice will be indispensable. - In slight cases, a decoction of the Soap-wort, or of Dandelion and Dog's-grass, in which a few drams of vitriolated kali arc dissolved, has been found of effectual service. Great benefit has, likewise, been derived from the liberal use of ace-tated kali, especially if administered at an early period. Brugnatelli, has for some lime employed with great success, the acidulated carbonate of lime.
In all calculous affections, the body should be regulated by the mildest laxatives, the good effects of which may be still farther promoted by moderate exercise on horse-back ; though the same caution ought to be observed in this respect, as well as in the use of emetics; for every violent effort, or concussion of the viscera, tends to aggravate the complaint.